Addiction psychiatrist
From Drug Rehab Wiki
An addiction psychiatrist is a board-certified psychiatrist who has received formal training in a subspecialty program and clinical experience in addiction medicine. Psychiatric physicians must undergo a year-long advanced training fellowship before sitting for the American Board of Psychiatry and Neurology (ABPN) subspecialty examination in addiction psychiatry.
The American Society of Addiction Medicine (ASAM) has provided a certification examination in addiction, but it is open to all specialty physicians and does not require a residency program; this certification is not recognized by the American Board of Medical Specialties (ABMS). Almost all American medical school graduates achieve certification through an ABMS board member exam. To receive certification as an addiction psychiatrist, candidates must complete training in an Accreditation Council for Graduate Medical Education (ACGME) accredited PGY-V addiction psychiatry residency prior to the Subspecialty Certification in Addiction Psychiatry examination.
Alcohol and drug abuse history is well documented throughout U.S. medical history, but the federal government did not develop an official educational psychiatric program in addiction medicine until the early 1970s. The Career Teachers in Alcoholism and Drug Abuse was created by the U.S. government in 1972, but was terminated in 1981 since funding for the three-year grants were deemed unproductive. New funding, programming, and research clinics were needed to help re-conceptualize substance abuse treatment training programs. Finally, in 1985, the medical, psychological, psychiatric, and social treatment for substance abuse disorders was mandated into psychiatric residency programs. In 1986, the ASAM created its certification program for all general physicians to help make practitioners more prepared to treat substance abuse-related medical cases. Then in 1987, the ABMS founded specialty certification training that required participants to complete a year-long subspecialty program in addiction medicine and an examination conducted by a board-certified member.
In 1993, the ABPN—influenced by research from the American Academy of Addiction Psychiatry (AAAP)—began its subspecialty certification in addiction psychiatry examination. Board-certified psychiatrists with clinical experience were eligible for the exam, but by the mid 1990s the residency fellowship became required. Since 1995, the ACGME has conducted addiction psychiatry residencies. Most recently, substance abuse treatment and recovery methods have been incorporated into internal medicine residencies as well. Until these specific prevention, treatment, and recovery standards were added to the field of psychiatry, addiction medicine was seriously overlooked in medical education practice. Around 40 addiction psychiatry residency programs are now available across the U.S., with approximately 20 new certified specialists being accepted each year.
A residency program requires that a resident acquire the skills, knowledge, and clinical experience of the following:
• Signs and symptoms of the use and abuse of all the major categories of substances VA.2.a–g (including alcohol, opioids, nicotine, amphetamines, stimulants, hallucinogens, benzodiazepines, sedative hypnotics, anxiolytics, and inhalants) and the types of treatment required
• Signs of withdrawal from VA.2.a–g substances; range of options for treatment of the withdrawal symptoms; complication commonly associated with such withdrawal
• Signs and symptoms of overdose; medical and psychiatric sequelae of overdose; and proper treatment of overdose
• Inpatient management of detoxification for substance-related disorders
• Signs and symptoms of the social and psychological problems and medical and psychiatric disorders caused by persistent use and abuse of substances, including problems in pregnant substance abusers and the fetus, family systems, and HIV infected users
• Psychoactive medications for treating psychiatric disorders caused by substance-related disorders
• Confrontation and intervention techniques for use on a substance abuser and his or her resistance
• Psychotherapeutic modalities for long-term management of substance abuse including family, group, motivational, cognitive-behavioral, and relapse prevention therapies; self-help programs; and replacement therapy
• Collaboration with other health professionals and providers; teaching and supervising team in administering care for substance abuse disorders; and leading multidisciplinary teams
• Genetic vulnerabilities, risk factors, protective factors, epidemiology, and prevention of substance-related disorders
• Major medical journals, scientific organizations, research reports, clubs, conferences, and seminars on substance-related disorders and treatment
• Current quality assurance measures, cost effectiveness, and economic structures for providing psychiatric/healthcare treatment to substance abusers
• How to evaluate, consult, and treat addicted patients and their families; medical, surgical, and intensive care patients with substance-abuse disorders; psychiatric inpatients and outpatients with comorbid psychiatric disorders and substance-abuse disorders; addicted patients with medical conditions
• Treatment of a minimum of five addicted patients over more than six months
• Rotation with chronic substance-abuse inpatient and outpatient settings involving neuropsychiatric evaluation
